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Physician-focused value-based models pave way for radiologists to reap incentives

MACRA gives specialists ability to reap reimbursement benefits tied to high quality, study says.

Jeff Lagasse, Associate Editor

Physician-focused payment models provide a prime opportunity for radiologists to demonstrate and be rewarded for their contributions to patient care, according to a new report by the Harvey L. Neiman Health Policy Institute.

Those models may also foster greater radiologist participation in advanced alternative payment models under the Medicare Access and CHIP Reauthorization Act of 2015, the report said.

"MACRA will look to increasingly shift physicians into APMs that incentivize quality and value," said Andrew Rosenkrantz, lead study author and a Neiman Institute affiliate research fellow, in a statement. "PFPMs will provide a path for physician specialty societies to develop and propose new practice models that will allow a more diverse range of physician specialists to participate in alternative payment models."

[Also: Nearly 85% of independent physicians unsure of MACRA requirements]

MACRA describes alternative payment models as new approaches to paying for medical care that incentivizes higher quality and value. MACRA incentivizes increasing participation in APMs by all physician specialties over the coming years. A fraction of APMs will meet criteria to be deemed an Advanced APM. Clinicians who are dubbed a "Qualifying Professional" in an APM are slated to receive substantial benefits under MACRA, including an automatic 5 percent payment bonus regardless of their performance and savings within the APM, as well as a larger increase in fee schedule payment rates beginning in 2016.

According to the report, existing APMs meeting the criteria to be Advanced APMs are most relevant to primary care physicians, with relatively limited opportunity at present for radiologist participation.

PFPMs are APMs that target the quality and cost of physician services and must address a new issue or specialty compared with existing APMs. They're intended to foster a much more diverse range of PFPMs that encompass a wider range of specialties.

Twitter: @JELagasse

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